骨小梁金属髋臼假体对人工全髋关节置换术后髋臼侧假体周围骨密度的影响  

Influence of trabecular metal acetabular component on bone mineral density around acetabular component after total hip arthroplasty

作　　者：朱金宏[1] 易诚青[2] 马春辉[2] 曹云[2] 

机构地区：[1]昆山市第一人民医院骨科,昆山215300 [2]上海交通大学附属第一人民医院骨科,上海200080

出　　处：《上海交通大学学报（医学版）》2012年第12期1540-1543,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的比较骨小梁金属(TM)髋臼与钛合金金属(Ti)髋臼术后短期临床预后及髋臼侧骨密度(BMD)变化,观察TM对人工全髋关节术后髋臼侧骨质变化的影响。方法随访TM组患者15例和Ti组患者13例,比较两组病例术后髋关节Harris评分;观察X线平片上髋臼假体与骨界面有无放射性透亮线,根据Hodgkinson系统予以分级;利用双能X线骨密度仪(DEXA)分别于髋臼Ⅰ、Ⅱ和Ⅲ区取直径为1 cm的圆形感兴趣区域(ROI)测量BMD。结果两组病例术后髋关节Harris评分比较,差异无统计学意义(P>0.05)。所有病例Hodgkinson系统分级皆为0级,未见假体松动移位。DEXA测量结果显示:Ti组术后患侧髋臼假体周围所有ROI的BMD值较健侧均有明显下降(P<0.05);TM组术后患侧髋臼假体周围各ROI的BMD值与健侧比较,差异均无统计学意义(P>0.05);两组间ROIⅠ区和Ⅱ区术后BMD变化比例的差异有统计学意义(P<0.05),而两组间ROIⅢ区BMD变化比例的差异无统计学意义(P>0.05)。结论 TM髋臼和Ti髋臼对术后髋臼侧骨质保留有重要意义。Objective To compare the short-term clinical outcomes and bone mineral density （BMD） around acetabular component between total hip arthroplasty with trabecular metal （TM） and that with Titanium alloy metal （Ti）, and investigate the influence of TM acetabular component on BMD around acetabular component after total hip arthroplasty. Methods Fifteen patients undergoing total hip arthroplasty with TM （TM group） and 13 patients undergoing total hip arthroplasty with Ti （Ti group） were followed up. Harris hip scores after operation were compared between groups. Hodgkinson grading was performed according to the findings of X-ray plain film. BMD around acetabular component was determined by dual energy X-ray absorptiometer （DEXA） based on the regions of interest （ROI） I , Ⅱ and Ⅲ Results There was no significant difference in the Harris hip scores after operation between two groups （ P 〉 0.05）. Hodgkinson grade 0 was identified in all patients, and there was no component loose or displacement after operation. DEXA measurement indicated that BMD values in all ROI around acetabular component of the operational side were significantly lower than those of the nonoperational side in Ti group （P 〈 0.05）, while there was no significant difference between BMD values in all ROI around acetabular component of the operational side and those of the nonoperational side in TM group （ P 〉 0.05）. The difference between BMD values in ROI I and ROI 11 before operation and those after operation in TM group was significantly different from that in Ti group （P 〈 0.05）, while the difference between BMD value in ROI m before operation and that after operation in TM group was not significantly different from that in Ti group （P 〉 0.05）. Conclusion TM acetabular component has favorable influence on BMD around acetabular component after total hip arthroplastv.

关 键 词：骨小梁金属 人工全髋关节置换术 骨丢失 骨密度 

分 类 号：R687.4[医药卫生—骨科学]